SCHOOL OF ENGINEERING

Pre-Engineering Program (PEP)

University of Connecticut
School of Engineering
Pre-Engineering Program Application

Please fill in the following information:

If you are experiencing any technical difficulty with the online application, please download a hard copy here and mail to address list on application, email to edpsw@engr.uconn.edu or fax to (860) 486 - 3045.


Registration

Only money orders or checks are accepted. Please make checks payable to UCONN and mail them to the following Pre-Engineering Program address.



** Program costs are NON-REFUNDABLE

Pre-Engineering Program
191 Auditorium Road U-3187
Storrs, CT 06269-3187


Personal Information









Gender
Grade
US Citizen
Permanent Resident
Age:
Ethnicity

School Information

Pre-Engineering Transportation/Emergency Waiver To contact in case of emergency:
Parent/Guardian


Friend/Relative


Family Physician

Health Insurance


Pre-Engineering Health/Emergency Waiver I waive all liability of the University of Connecticut during the participation of my child (Participant's Name)
in the Pre-Engineering Program. I understand that the University will not be responsible for any costs related to emergency or any other hospital visits, accidents or illness. As parent or legal guardian of the above student, I agree to pay all health related costs that may arise during my son or daughter's participation in the Pre-Engineering Program.


Statement of Consent
I give
(Student's Name)
my consent to participate in the Pre-Engineering Program at the UCONN Storrs Campus and to participate in field trips organized by the program.

In doing so, I agree to the following:
  1. In case of a medical emergency, I grant the chaperones the right to authorize medical care, if the Parent/Guardian named above cannot be reached.
  2. I will arrange transportation for and pay all the expenses of returning my child home before termination of the event if he/she does not adhere to school rules as stated by the UCONN Pre-Engineering Program Director.
  3. The school is not responsible for damage or loss of property personally owned by my child.
  4. I will make the necessary arrangements to provide transportation for my child upon his/her return to the school.

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